Virkningen af losartan versus atenolol på kardiovaskulaer morbiditet og mortalitet hos patienter
med hypertension og ekg-verficeret venstre ventrikelhypertrofi i LIFE-undersögelsen
Engelsk titel: The effect of losartan versus atenolol on cardiovascular morbidity and mortality in patients with
hypertension and ECG-verified left ventricular hypertrophy in the LIFE-study
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Författare:
Ibsen H
;
Lederballe Pedersen O
;
Dahlöf B
;
Kjeldsen SE
;
Lindholm LH
Språk: Dan
Antal referenser: 12
Dokumenttyp:
RCT
UI-nummer: 03021035
Sammanfattning
Introduction: Left ventricular hypertrophy is a strong independent predictor of risk of cardiovascular morbidity and death. The aim of the LIFE-study was to establish whether treatment with the angiotensin-II AT 1-receptor antagonist, losartan, reduced cardiovascular events more effectively than treatment with the betablocker atenolol in patients with hypertension and left ventricular hypertrophy. Material and methods: The LIFE-study included 9193 patients with essential hypertension and ECG-verified left ventricular hypertrophy, age range 55 - 80 years, systolic blood pressure in sitting position 160 - 200 mmHg and/or diastolic blood pressure 95 -115 mmHg. Patients were randomized to double-blind treatment with losartan versus atenolol. They were followed for at least four years and until 1040 patients had a primary cardiovascular event (cardiovascular death, myocardial infarction or stroke). Results: Blood pressure fell by 30.2/16.6 and 29.1/16.8 mmHg in the losartan and the atenolol group, respectively. The primary composite endpoint occurred in 508 losartan and 588 atenolol patients (relative risk 0.87, p = 0.021). A total of 232 and 309, respectively, had fatal or non-fatal stroke (relative risk 0.75, p = 0.001). There was no difference in myocardial infarction. New-onset diabetes was 25% less frequent on losartan. Side effects were less on losartan compared to atenolol. Discussion: Losartan prevents to a higher degree cardiovascular morbidity and death than atenolol for a similar reduction in blood pressure and is better tolerated.